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1.
Am J Otolaryngol ; 42(2): 102861, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33445041

RESUMEN

PURPOSE: Laryngeal dysplasia represents a series of precancerous lesions, observed as laryngeal leukoplakia. General agreement has been lacking for their management and treatment ranging from simple biopsy to complete excision with cold blade/laser. In this work, we aim at providing the oncological outcomes of patients affected by laryngeal dysplasia, treated with a single modality, and at identifying clinical parameters predictive of malignant transformation. MATERIALS AND METHODS: We performed a retrospective analysis of patients treated with transoral laser microsurgery between January 2005 and December 2015 in a tertiary comprehensive cancer centre. Data were collected about smoke and alcohol habits, site of the laryngeal lesion, surgical outcomes and progression to invasive squamous cell carcinoma. RESULTS: The grade of dysplasia, margins' status and smoke habit were not associated with a significantly worse DFS and a higher risk of invasive SCC. We identified three parameters (supraglottic involvement, multifocality and history of more than one recurrence of dysplasia) that have a significant prognostic value. CONCLUSIONS: On the base of these clinical parameters, a more intensive follow-up might be warranted for high-risk patients.


Asunto(s)
Instituciones Oncológicas/estadística & datos numéricos , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Transformación Celular Neoplásica , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/terapia , Lesiones Precancerosas , Centros de Atención Terciaria/estadística & datos numéricos , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/etiología , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Laríngeas/epidemiología , Neoplasias Laríngeas/etiología , Masculino , Oportunidad Relativa , Estudios Retrospectivos , Riesgo , Fumar/efectos adversos , Resultado del Tratamiento
2.
Eur Arch Otorhinolaryngol ; 267(11): 1735-42, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20499077

RESUMEN

Eighty patients affected by supraglottic cancer were treated by transoral carbon dioxide laser surgery between 1989 and 2006 in two Italian institutions. Patient staging was as follows: 2 pTis, 20 pT1, 38 pT2, and 20 pT3. Simultaneous or 1-month delayed neck dissection (ND) was performed on 27 (34%) patients, unilaterally in 10 and bilaterally in 17. The pN category was as follows: 9 pN0, 6 pN1, 8 pN2b, and 4 pN2c. A total of 16 (20%) patients received complementary radiotherapy (RT) and 5 (6%) were subjected to chemo-RT for persistent tumor after re-excision due to positive margins, multiple lymph nodes, and/or extracapsular spread after ND. The last follow-up was in December 2008. The 5-year overall, disease-specific and disease-free survivals, local control with laser alone, and organ preservation rates calculated by Kaplan-Meier analysis were 84.4, 97.4, 88.3, 96, and 97.2%, respectively. Univariate analysis showed a statistically significant impact on disease-free survival, local control with laser alone, and organ preservation of pT category (p = 0.009, p = 0.01, and p = 0.03, respectively), while pN category and tumor stage negatively influenced disease-free survival (p = 0.007 and p = 0.01, respectively). This series confirms the good overall oncologic outcomes obtained by transoral laser surgery for Tis, T1, T2, and selected T3 supraglottic cancer with minimal pre-epiglottic space involvement.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Laríngeas/cirugía , Terapia por Láser/métodos , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Terapia Combinada , Femenino , Humanos , Neoplasias Laríngeas/patología , Terapia por Láser/instrumentación , Láseres de Gas , Metástasis Linfática , Masculino , Microcirugia/instrumentación , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Pronóstico , Tasa de Supervivencia , Resultado del Tratamiento
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